Objective: To explore prospectively the relationship between the state of perimesencephalic cistern and the degree of deformation of the midbrain on CT scanning and the outcome of the patients with acute craniocerebral injury.
Methods: The CT scan features including the states of perimesencephalic cisterns, the deformations of the midbrain and the ratios of the occipitofrontal diameter and the transverse diameter of the midbrain of 132 cases were measured. The GOS of the patients 3 months after trauma were regarded as outcome.
Results: The rate of unfavorable outcome (dead, vegetative status, severe disability) was significantly correlated with perimesencephalic cistern narrower than 1 mm (P<0.05), especially narrower than 0.5 mm (P<0.005), deformed midbrain (P<0.005) or abnormal ratio (<0.9 or >1.1) of the occipitofrontal diameter and transverse diameter of the midbrain (P<0.01). But the patient's perimesencephalic cistern wider than 1mm and the patients without deformed midbrain got favorable outcome (moderate disability/good recovery).
Conclusions: The state of the compressed perimesencephalic cistern (<1 mm) and the deformation of the midbrain may significantly indicate unfavorable outcome of the patients with acute craniocerebral injury.
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Neurocrit Care
January 2025
Departments of Critical Care Medicine and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Background: Controlled donation after circulatory determination of death (DCD) is feasible only if circulatory arrest occurs soon after withdrawal of life-sustaining measures (WLSM). When organ recovery cannot proceed because this time interval is too long, there are potential negative implications, including perceptions of "secondary loss" for patients' families and significant resource consumption. The DCD-N score is a validated clinical tool for predicting rapid death following WLSM.
View Article and Find Full Text PDFOper Neurosurg (Hagerstown)
December 2024
Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background And Importance: We describe, to our knowledge, the first report of fully endoscopic microvascular decompression (MVD) of the trochlear nerve in a patient with superior oblique myokymia (SOM).
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Surg Neurol Int
November 2024
Department of Neurosurgery, Mount Sinai Health System, New York, United States.
Background: This study primarily aimed to assess the volumetric attributes of the midbrain and perimesencephalic structures preoperatively and following surgical interventions in patients diagnosed with brain herniation secondary to traumatic brain injury (TBI).
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Surg Neurol Int
August 2024
Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center, Hidaka, Japan.
Background: Various degrees of thrombosis have been reported in patients with giant aneurysms. However, small, unruptured aneurysms rarely resolve spontaneously. Herein, we report a case of a small unruptured aneurysm in the clinoid segment (C3) of the left internal carotid artery (ICA) that showed almost complete occlusion at the 1-year follow-up.
View Article and Find Full Text PDFWorld Neurosurg
September 2024
Botucatu Medical School, São Paulo State University, UNESP, São Paulo, Brazil.
A 54-year-old woman with no relevant medical history presented with severe headache, nausea, and vomiting for 8 days. Imaging examination revealed a subarachnoid hemorrhage in the left interpeduncular cistern without aneurysms. Computed tomography angiography and digital subtraction angiography found an anomalous vein near the site of the hemorrhagic clots, indicating abnormalities in cerebral venous drainage that provided an anastomosis between the drainage system of the deep middle cerebral, petrosal, and lateral mesencephalic veins.
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